Mencap - Kent and East Sussex Domiciliary Care Agency

East Sussex Dom Care Agency is a domiciliary care service providing personal care to 14 people at the time of the inspection. East Sussex Domiciliary Care Agency is owned by the Royal Mencap Society. The provider registered this service with us to provide personal care and support for people with learning disabilities. East Sussex Dom Care Agency provide personal care to supported living housing schemes in Hastings, St Leonards and Eastbourne.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People were protected from avoidable harm and abuse. Safeguarding policies and procedures

were embedded within practice and were consistently followed. Staff had recognised signs of abuse and had recorded their concerns.

People told us they were happy with the care they received, and that staff helped them to feel safe. Risk assessments and care plans were comprehensive and guided staff in how to provide care safely and in the way the person preferred. There were enough suitable staff employed to cover all the care visits. People said they received their calls on time and for the duration that they expected. Staff supported people to have their prescribed medicines safely.

People were supported to ensure their healthcare needs were met. One relative said, “They’re very sharp if there’s anything wrong and they support her with all appointments.” People were encouraged to live healthy lives and received food of their choice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People received kind and compassionate care. People’s independence was promoted by staff. People were treated with respect and dignity and supported to make decisions about their care.

The service applied the principles and values the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People received personalised care that was tailored to meet their individual needs, preferences and choices. Care plans were detailed and guided staff about people's needs and how to meet them. People’s concerns and complaints were listened to and used to improve the service they received. Staff had training and experience to provide end of life support when people needed it.

The registered manager and service managers were well regarded and had a clear vision for the service which was understood by the staff and embedded within their practice. There were effective quality assurance systems in place that were used to drive service improvements. People, their relatives and staff were asked for their feedback about the home and meetings were held regularly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good. (published 29 December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their homes and or the family home; we needed to be sure that someone would be available at the office.

East Sussex Domiciliary Care Agency is owned by the Royal Mencap Society. The provider registered this service with us to provide personal care and support for people with learning disabilities. They provide care in supported living housing schemes. At the time of our inspection 33 people received support with personal care.

There was a registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People we spoke with said they had support from regular staff who knew them well. Staff we spoke with recognised the different types of abuse. There were systems in place to guide staff in reporting any concerns. Staff were knowledgeable about how to manage people’s individual risks, and were able to respond to peoples’ needs. People were supported to receive their medicines by staff that were trained and knew about the risks associated with them.

Staff had up to date knowledge and training to support people. Staff always ensured people gave their consent to the support they received. The management team regularly reviewed how people were supported to make decisions. People were supported to eat and drink well. They explained they were supported to make their own decisions and be as independent as they could. People and their relatives told us staff would access health professionals as soon as they were needed. We saw there was effective communication with people, staff and health care professionals.

People and their relatives said staff and management team were caring and kind. They said people were treated with dignity and respect, and encouraged to be as independent as possible. People said they were involved in making choices about what they were supported with. Relatives told us they were involved as part of the team to support their family member. The management team were adaptable to changes in peoples’ needs and communicated changes to staff effectively.

People and their relatives knew how to raise complaints and the management team had arrangements in place to ensure people were listened to and appropriate action taken. Staff were involved in regular meetings, training and meetings to share their views and concerns about the quality of the service. People and staff said the management team were accessible and supportive to them.

People using the service were included in recruitment procedures for new staff. This encouraged staff to understand the importance of people using the service from the start of their employment.

The management team monitored the quality of the service in an inclusive way. The registered manager ensured there was a culture of openness and inclusion for people using the service and staff. The management team had systems in place to identify improvements and action them in a timely way.

One person told us, 'I love it here, I talk to (X) if I have any worries.' Another person said, 'Staff take me where I want to go. I like to go to the fish bar in Hastings.' One person said, 'I like spending time with my friends at the weekend.'

We observed that staff ensured that consent was obtained prior to providing care and support. We found that the domiciliary support plans in place were detailed and documented people's needs and how they should be met.

There were safe systems in place for the management of medication.

There was a robust staff recruitment procedure in place.

There were detailed systems to ensure that the quality of care provided was monitored and reviewed on a regular basis.

We looked at training records and training certificates, which verified that training had taken place. We saw records that showed that staff were up to date with their training.

We looked at seven care plans to see what improvements had taken place to the recording of information. We found that daily record sheets had been completed fully in all the files we reviewed. There was evidence in four of the care plans that we looked at to show that information had been updated.

There were revised storage arrangements for office based files. During the visit we observed the secure destruction of out of date files containing personal information.

We spoke with three members of staff and two managers. Staff told us that they had stayed in their job a long time because they loved the role they had in supporting people to be independent. One care worker told us, "I get a lot from encouraging people to achieve in all aspects of their life'. They told us they believed that people using the service could do whatever they wanted to and that the role of the care worker was to support these ambitions. Another care worker told us 'I help people understand what they are going to do. I provide step by step guidance so they learn to do it for themselves'.

We found that there were processes in place to support independence of people using services. However, there were some shortfalls in keeping records up-to-date. For example, centrally held support plans and risk assessments were out of date. We found that although staff training was recorded and monitored some mandatory training was out of date. We spoke with the local authority who told us they had concerns about record keeping as well.